Over the years many dental composites have been introduced, each composite possessing certain physical properties. However, substantially all of these dental composites can be categorized into two main groups, self-cured materials and light-cured materials.
The self-cured composites have involved free radical polymerization initiated by benzoyl peroxide (or another suitable peroxide) and accelerated, typically by a tertiary amine such as N,N,dimethyl-p-toluidine. The curing agents must be stored separately from the resin they are to cure, and they are mixed together just before use.
The light-cured composites have involved free radical polymerization initiated by the photoexcitation of light-sensitive compounds by ultraviolet or visible light. They are single-component systems, typically pastes, stored in opaque containers until the time of cure. Some of the photoinitiators that have been employed are the benzoin ethers, benzil ketals, dialkoxyacetophenones, benzophenones, thioxanthones, and hydroxyalkylphenones.
In the practice of dentistry, some tooth repairs have been better achieved by self-cured composites and some have been better achieved by light-cured composites. While many factors have helped to determine whether a dentist would or should choose a self-cured material or a light-cured material, the prime factors have been working time, setting time, and the architecture of the cavity preparation.
The light-cured composites, combined with special high-lumen lighting units employing fiber optics, have offered variable working times and fast "snap" sets. Setting can take between ten and forty seconds in many instances. However, the use of light-cured composites has been limited by the depth of the repair and the ease of light penetration. Relatively unobstructed, clean, shallow repair surfaces have been required. Visible-light-cured materials have helped in solving some of the limitations caused by repair depth, by roughly doubling the depths at which cure is effective as compared to ultra-violet light-cured material. Also, many dentists have felt more comfortable using a visible, as opposed to an ultra-violet, activating light source.
The amount of cure is variable and is a function of exposure to lumens of visible light. These facts result in extremely dangerous situations in many dental restorations; because most dentists do not realize this deficiency, because light-cured systems are advertised to be able to be cured through tooth structure. In reality, the situation is, at best, a gradient level of cure obtained in relation to the amount of lumens of light energy available to the restorative resin. That is to say, layers close to the light source undergo greater percent polymerization than the underlying layers. Consequently, the incompletely polymerized restoration may wash out leak, or fail in adhesion. Yet the surface or bulk of the restoration may appear clinically adequate, even though new secondary decay may be beginning, and, because of its concealment, result in death of the pulp or loss of the tooth.
When a light-cured resin liner is used with a light-cured paste composite at a depth of around 3 mm. or greater, the resin liner may not cure because of insufficient light reaching the resin. Uncured resin liner can cause leaching, pulpal irritation, and loss of adhesion. Heretofore, the resin liner had, therefore, to be polymerized prior to placement of the composite. With this invention, such double cure is unnecessary.
Self-cured systems have offered assurance of polymerization throughout the polymer mass used in any repair surface architecture. However, their use has been limited by manufacturer-determined work times and set times. The peroxide and the accelerator could be adjusted to give widely varying setting times; the quicker the set time, the quicker the placement had to be made. Thus, in order to give enough time for accurate placement, the set times had to be longer than were desirable. Generally, set times have been at least two or three minutes after mix, and placement has had to be completed within forty-five seconds after mix. This had made dentists work somewhat faster than was desirable for many placements, and even then the patient had to be immobilized longer than was desirable before the composition set.
This invention overcomes the deficiencies of light-cured systems, while preserving their functional benefits. It also overcomes the deficiencies of the self-cured systems by enabling quicker set times coupled with longer placement times, if desired.
The system of this invention thus offers the best properties of both types of curing systems without suffering from the limitations of either, and therefore it significantly advances the practice of dentistry and the science of dental materials.
The system of the present invention can be in a powder-liquid, paste-paste, paste-powder, or gel-powder form, so that there is no loss in versatility of possible embodiments.
Similar problems occur with porcelain repair systems in general, not only in dental uses, but for repairing such porcelain articles as bathtubs, and the invention solves these problems also.